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Biomedical subjects

S Winter

Publications and source records attributed to S Winter.

At least 109 records · Page 6Linked to original sources
PubMed1986

Cardiovascular effects of polycyclic antidepressants.

Every day, thousands of people in the United States receive polycyclic antidepressants (PCAs) prescribed by their primary care physicians. We have examined the cardiovascular manifestations of polycyclic antidepressants in 14 patients with primary depression receiving various antidepressant drugs for a period of six months or more. None had suffered from any systemic illness. All 14 received a commonly prescribed PCA, such as doxepin, amitriptyline, imipramine, desipramine or amoxapine, in therapeutic doses. None developed any significant adverse reaction. Left ventricular function, as determined by M-mode echocardiogram, was within normal limit in all patients. A twenty-four-hour ambulatory electrocardiogram revealed rare supraventricular ectopic beats in 8 patients and ventricular ectopic activity (Lown grade 1) in 4 patients. In 1 patient, who received additional lithium carbonate for treatment of depression, both supraventricular and ventricular ectopic activity developed on rare occasions. In 4 of the 8 patients the plasma concentration of PCA was optimal or near optimal, and in 4 of the 8 patients it was subtherapeutic (even though these 4 patients had shown clinical improvement with continued polycyclic therapy). It appears from the present data that antidepressant therapy with PCAs prescribed in therapeutic doses was well tolerated, without any significant adverse cardiovascular reaction, in otherwise healthy young patients with primary depression.

Adult↗
PubMed1985

Recurrent acute otitis media--prophylactic penicillin treatment: a prospective study. Part I.

Recurrent acute otitis media (RAOM) is a distressing clinical manifestation of middle ear pathology, mainly expressed in the first two years of life. In this controlled study, prophylactic treatment by phenoxymethyl penicillin reduced significantly the frequency of RAOM in 60 children, as compared to 48 children who received a short ampicillin course only on the occasion of an acute otitis media episode. The importance of breastfeeding, age at initial episode, the type of treatment given and the pertinent literature is discussed. A working hypothesis of this prophylactic treatment is suggested.

Acute Disease↗
PubMed1985

Cytokeratin patterns of human oral epithelia: differences in cytokeratin synthesis in gingival epithelium and the adjacent alveolar mucosa.

Human oral mucosa includes various epithelia that are commonly classified as lining, masticatory, and specialized epithelia. Although adjacent tissues, the gingiva and alveolar mucosa represent two different types of epithelia: the gingiva is cornified and exhibits high rate ridges, whereas the mucosa does not normally cornify and exhibits a relatively smooth-contoured borderline between the epithelium and the underlying connective tissue. We examined the cytokeratin patterns of both epithelia using one- and two-dimensional gel electrophoresis. The gingiva expresses a great complexity of cytokeratins, including significant amounts of components nos. 1, 2, 5, 6, 10, 11, 13, 14, 16, and 17, as well as traces of cytokeratins nos. 4 and 15, i.e., a pattern similar to those of vaginal mucosa and epidermis containing proliferative keratinocytes. In contrast, the alveolar mucosa contains only two major cytokeratins, i.e., nos. 4 and 13, together with two minor amounts of cytokeratins nos. 5, 6, 14, and 17, thus resembling the patterns of certain other stratified, noncornified epithelia, such as the esophagus. Immunofluorescence microscopy using monoclonal antibodies to cytokeratins nos. 4 and 13 revealed the presence of these proteins in the suprabasal layers of alveolar mucosa, whereas in the gingiva, only certain small, suprabasal clusters of cells appeared to contain these cytokeratins. The cytoskeletal differences between gingival and alveolar mucosa are discussed in relation to the differences in their morphology and function, and with respect to pathological processes characteristic of these epithelia.

Cytoskeletal Proteins↗
PubMed1984

Problem-oriented record: effect on problem identification in the hospital.

The problem-oriented record (POR) is a medical record format that consists of a standard data base, a problem list, problem-oriented plans and problem-oriented progress notes. It has been claimed repeatedly that the use of a POR improves medical care. The effect of the standard data base and problem list components of the POR on the process of care was determined. Process of care was defined as the quantity and type of data collected and the number of problems identified per patient, which were measured before and after introduction of the POR into the pediatric wards of a regional university hospital, using a standardized audit technique. The same measures were also made in the pediatric wards of two similar hospitals at which the POR had not been introduced. Data collection scores in the experimental hospital for both subjective and objective data increased significantly both after POR implementation and also in comparison with the two other hospitals. The type of data collected was determined by the POR forms. The number of problems identified increased, but not significantly. We conclude that the standardized data base and problem list components of the POR can increase the amount and determine the type of data collected in pediatric wards, while not significantly affecting the number of problems identified.

Child↗
PubMed1983

Role of myocardial ischemia in the genesis of stress-induced S-T segment elevation in previous anterior myocardial infarction.

This study tests the hypothesis that myocardial ischemia is responsible for exercise-induced S-T segment elevation in patients with previous anterior myocardial infarction (MI). Exercise stress testing in conjunction with thallium imaging of the myocardium was performed in 28 patients with previously documented anterior MI. Thallium images were analyzed by computer for the presence of initial uptake defects and evidence of abnormal clearance of the isotope from the myocardium (that is, imaging evidence of ischemia). Total S-T segment elevation (sigma ST) in precordial leads V1 to V6 at rest was subtracted from sigma ST at peak stress in order to quantitate the extent of S-T elevation induced by stress (delta ST). Two groups of patients were identified; 1 with stress-induced S-T elevation (Group I, delta ST greater than or equal to 4.0 mm) and 1 without this abnormality (Group II, delta ST less than 4.0 mm). Evidence of abnormal thallium washout from myocardial scan segments occurred in 12 of 15 Group I patients versus 9 of 13 Group II patients (difference not significant). In addition, abnormal tracer washout from anterolateral or septal scan segments occurred in 5 patients in each group. Likewise, abnormal thallium clearance from inferior or posterior scan segments occurred in 8 of 15 Group I patients versus 7 of 13 Group II patients (difference not significant). The patient with the greatest amount of stress-induced S-T elevation (S-T 11.5 mm) had no evidence of ischemia during the stress test. However, Group I patients did have larger anterolateral plus septal initial thallium uptake defect scores than did those of Group II (10 of 15 with defect score greater than or equal to 350 in Group I versus 1 of 13 in Group II, p less than 0.002). Similarly, resting left ventricular ejection fraction greater than or equal to 30% was present in only 4 of 15 Group I patients versus 13 of 13 in Group II (p less than 0.001). Finally, multiple stepwise linear regression analysis demonstrated that delta ST correlated best with the extent of initial anterolateral plus septal thallium uptake defect score (F = 17.3, p less than 0.001) and to a lesser extent with resting ejection fraction (F = 5.2, p less than 0.05) and change in heart rate from rest to peak stress (F = 8.1, p less than 0.01; corrected multiple correlation coefficient = 0.76, p less than 0.001). Thus, in patients with previous anterior MI (1) exercise-induced myocardial ischemia occurs as often with as without S-T segment elevation, (2) myocardial ischemia is not required for the production of stress-induced S-T segment elevation, and (3) stress-induced S-T elevation primarily reflects the extent of previous anterior wall damage and to a lesser extent an increase in heart rate between rest and peak stress.

Adult↗
PubMed1983

Butyrophilin, an apical plasma membrane-associated glycoprotein characteristic of lactating mammary glands of diverse species.

Lipid globule membranes were isolated from human and bovine milk and from the milk of sheep, goat, pig, rat and guinea pig, and their polypeptide compositions were analyzed. The major polypeptides with molecular weights similar to that of bovine butyrophilin were separated by gel electrophoresis, isolated and characterized with respect to isoelectric point, molecular weight, immunological cross-reactivity and peptide composition after proteolytic cleavage. We show that in all species examined these proteins are similar to bovine butyrophilin in (i) their relative insolubility in buffers of low and high ionic strength and in non-denaturing detergents, (ii) the occurrence of several isoelectric variants, and (iii) patterns of peptides obtained by protease digestion. It is concluded that closely related proteins are major constituents of the cytoplasmic coat structures associated with milk lipid globule membranes of many species, and we propose the name butyrophilins for this group of proteins. Bovine and human butyrophilins are glycosylated with relatively large amounts of glucosamine, mannose, glucose and galactose but little fucose, sialic acids or galactosamine. Most if not all of the sugar residues are associated with an acetone-soluble peptide fragment of Mr 12000-16000 focusing at about pH 4.0. We suggest that this fragment contains a membrane-spanning peptide sequence and is involved in the attachment of the cytoplasmic coat to the membrane of the milk lipid globule.

Animals↗
PubMed1983

Protein complexes of intermediate-sized filaments: melting of cytokeratin complexes in urea reveals different polypeptide separation characteristics.

Subunit complexes of cytokeratin polypeptides from intermediate-sized filaments (IF) of various tissues and cultured cells from rat, cow, and man were solubilized in low-salt buffer containing 4 M urea and exposed to increasing concentrations of urea, followed by urea gradient electrophoresis or two-dimensional gel electrophoresis at different urea concentrations. Correspondingly, cytokeratin polypeptides dissociated in 9.5 or 10 M urea were dialyzed into lower concentrations of urea and allowed to reassociate into specific complexes. It was found that the polypeptide constituents of a given cytokeratin complex dissociate in the form of a rather sharp "melting curve" and that dissociated polypeptides reassociate in the same mode of dependence on urea concentration. The midpoint of melting in urea (Um) is a characteristic property of a given complex of cytokeratin polypeptides. Um values differ markedly between different cytokeratin complexes, ranging from 5.9 to 9.0 M urea. The results also show that cytokeratins do not form complexes with vimentin, another type of IF protein. The data suggest that certain cytokeratin polypeptides are complementary and contain sequences that direct their association into specific complexes forming IF subunits.

Animals↗
PubMed1983

Nonketotic hyperglycinemia: two patients with primary defects of P-protein and T-protein, respectively, in the glycine cleavage system.

The glycine cleavage system was investigated in the livers and brains of two patients with typical nonketotic hyperglycinemia who died in the neonatal period. The overall activity of the glycine cleavage system was found to be extremely low in both the liver and brain of each patient. In one patient, the disturbance of the glycine cleavage system was due to absence of activity of the P-protein. Immunochemical analysis indicated that this resulted from an absence of the enzyme protein. In the other patient, the activity of the T-protein was undetectable in the brain and was extremely low in the liver. Clinically classic nonketotic hyperglycinemia resulted from molecular defects in two different protein components of the glycine cleavage system.

Amino Acid Metabolism, Inborn Errors↗
PubMed1983

[Anastomosis healing in the irradiated colon. II. Influence of irradiation on new formation of connective tissue. An animal experiment study].

With regard to the permanent increase of perioperative irradiations in case of colorectal tumors, the possible influence of irradiation on the healing of anastomoses has been investigated. 230 rats were submitted to an irradiation of the rectosigmoidal region corresponding to the therapeutic method employed in human patients (focal dose of 50 Gy, in fractions of 4 x 2 Gy per week, interval of three weeks without irradiation). Rectosigmoidal anastomoses were performed one day, four weeks, eight weeks, and four months after the irradiation. The increase of connective tissue which is decisive for the stability of the anastomosis and which can be additionally induced by irradiation, was determined 3, 7, 14 and 21 days after the operation by identification of the hydroxyproline concentration within the anastomotic region. A comparison with nonirradiated animals shows that irradiation induces an additional formation of new connective tissue which becomes more intensive as the time interval since the finishing of irradiation is longer.

Animals↗